Pelvic peritonitis

　　Pelvic infection is an important cause of pelvic peritonitis, and the factors that trigger this disease usually include the following points:

　　1. Neglect of hygiene

　　Unhygienic practices during menstruation, sexual intercourse during menstruation, and unclean sexual intercourse can lead to the occurrence of pelvic peritonitis.

　　2. Unsterile uterine cavity manipulation

　　Infections such as post-abortion infection, unsterile obstetric surgery, etc., can cause pelvic peritonitis.

　　3. Spread of acute salpingitis

　　During acute salpingitis, pus in the lumen of the fallopian tube may overflow through the abdominal orifice, or the surrounding inflammation of the fallopian tube may spread directly to cause inflammatory changes in the pelvic peritoneum.

　　4. Secondary to pelvic cellulitis

　　Pelvic cellulitis refers to the inflammation of connective tissue outside the pelvic peritoneum. The pelvic connective tissue includes the connective tissue in the areas of the uterine sides and the anterior bladder interspace, as well as the connective tissue behind the pelvic peritoneum.

　　5. Other surgical diseases

　　Such as appendicitis, diverticulitis perforation, etc., which can spread and cause pelvic peritonitis.

　　Pelvic peritonitis is a relatively serious infectious disease. If it is not handled promptly and effectively, it may lead to multiple organ failure, fluid loss, infection spreading to the abdominal cavity and intestines, causing severe dehydration and electrolyte disorder. Patients may appear with a mask-like expression (Hippocratic face), and may die within a few days.

　　Since acute pelvic peritonitis is rarely primary, there is often a history of acute pelvic organ inflammation before the onset, which is as follows:

　　1. Fever

　　Patients often experience high fever, chills, with body temperature reaching 40℃ or higher.

　　2. Pain

　　Patients often experience severe spasmodic lower abdominal pain, which is persistent. Pain during urination and defecation, with occasional diarrhea or constipation.

　　3. Mental status

　　Severe cases may present with restlessness, general fatigue, and even confusion, delirium, and coma.

　　4. Other symptoms

　　Severe patients may experience shock, blood pressure drop, pale complexion, dry tongue, cold sweat, and subsequent collapse, heart failure, pulmonary edema, and other symptoms. In the chronic stage, palpable irregularities and masses of different sizes can be felt on the surface of the reproductive organs, omentum, and intestines.

　　Pelvic peritonitis has a significant impact on women's health, and in severe cases, it can even threaten life. It is very important to do a good job in prevention work.

　　1. Firstly, women should pay attention to the health preservation and sexual hygiene during menstruation, postpartum, and after abortion;

　　2. When undergoing abortion, intrauterine device insertion, other intrauterine surgical procedures, and childbirth, go to a regular hospital to avoid poor sterilization and artificial infection caused by human factors.

　　3. Maintain a cheerful mood and pay attention to the combination of work and rest.

　　4. Abstain from sexual intercourse when there is vaginal bleeding.

　　For the diagnosis of pelvic peritonitis, the following examination measures can generally be adopted:

　　1. Physical examination:Acute illness appearance, fever, marked tenderness and rebound tenderness in the lower abdomen, or presenting as a board-like abdomen. The vaginal mucosa in gynecological examination may show congestion, there may be purulent discharge at the cervix. During bimanual examination, the fornix tenderness is marked. If there is a pelvic rectal pouch abscess, the tenderness in the posterior fornix is more marked, or a sense of fullness and fluctuation may be felt. Rectal examination may feel fluctuations and bulges on the anterior wall of the rectum.

　　2. Imaging diagnosis:When abscess formation is detected by ultrasound, the B-ultrasound instrument can detect a mass, which is often irregular in outline, with dense echo around it, and an echo-free area inside.

　　3. Laboratory diagnosis:Percutaneous abdominal puncture and posterior fornix puncture can withdraw fluid, mostly pale yellow, thin, hemorrhagic fluid, yellow exudative fluid or pus. The fluid can be sent to the laboratory for testing or for bacterial culture.

　　4. Peripheral blood leukocyte count:The number of neutrophils is increased, the erythrocyte sedimentation rate is accelerated, and pathogenic bacteria can be cultured from cervical secretion or blood culture.

　　Pelvic peritonitis can cause serious harm to patients. To enhance the therapeutic effect, patients might as well try the vegetable radish soup, which has a good effect on this disease.

　　1. Composition: Dandelion 100 grams, chrysanthemum 20 grams, dandelion 25 grams, and sliced radish 200 grams.

　　2. Dosage: Boil the above four ingredients together, eat the radish and drink the soup after removing the medicine. One dose per day.

　　3. Function: Clear heat and detoxify.

　　4. Main Indications: Pelvic inflammation belongs to the type of damp heat and blood stasis, with symptoms such as fever, lower abdominal pain, pain and tenderness in the lower abdomen, refusal to press on both sides of the lower abdomen, yellowish leukorrhea, red tongue coating, and slippery and rapid pulse.

　　5. Note: Chrysanthemum has varying degrees of inhibitory effects on a variety of bacteria such as staphylococcus, streptococcus, pneumococcus, Escherichia coli, Pseudomonas aeruginosa, and dermatophytes.

　　Pelvic peritonitis often coexists with other pelvic organ infections, especially with salpingitis, which is the most common. At present, the main treatment methods for this disease are as follows:

　　1. Physical Therapy

　　Warm and benign stimulation can promote pelvic blood circulation, improve the nutritional status of local tissues, and facilitate the absorption and regression of inflammation. Common physical therapies include shortwave, ultrashortwave, infrared, audio, iontophoresis, etc. However, do not use physical therapy if the body temperature is above 37.5℃ or if there is tuberculosis of the reproductive organs.

　　2. Tissue Therapy

　　Tissue therapy includes the use of placental tissue fluid, placental globulin, intramuscular injection, once a day or every other day, 15 times as a course.

　　3. Antibiotic Treatment

　　All patients with acute pelvic peritonitis should undergo bacterial culture of cervical secretion or posterior fornix puncture fluid, or perform blood culture and drug sensitivity test, and choose effective antibiotics based on this.

　　4. Surgical Treatment

　　Surgical treatments include incision and drainage and laparotomy for excision of the focus. When pelvic peritonitis has formed an abscess and the position of the abscess has reached the pelvic floor, incision and drainage can be performed through the posterior fornix, but since the abscess is located in the abdominal cavity, drainage can only temporarily alleviate the symptoms and often cannot cure the disease. When the pelvic abscess forms and ruptures, laparotomy can be performed under the control of a large amount of antibiotics to remove the focus, which is the most effective and rapid method.